...2009 Nursing Turnover: Costs, Causes, & Solutions Steven T. Hunt, Ph.D., SPHR Director of Business Transformation SuccessFactors Inc. (www.successfactors.com) E-mail: shunt@successfactors.com Copyright © 2009 SuccessFactors, Inc. Invest in People …. Drive Business Results SuccessFactors Healthcare Executive Summary Nursing turnover is a major issue impacting the performance and profitability of healthcare organizations. Healthcare organizations require a stable, highly trained and fully engaged nursing staff to provide effective levels of patient care. The financial cost of losing a single nurse has been calculated to equal about twice the nurse’s annual salaryi. The average hospital is estimated to lose about $300,000 per year for each percentage increase in annual nurse turnoverii. Losing these critical employees negatively impacts the bottom line of healthcare organizations in a variety of ways including: Decreased quality of patient care Increased contingent staff costs Increased staffing costs Loss of patients Increased nurse and medical staff turnover Increased accident and absenteeism rates The primary causes of nurse turnover can be analyzed by I) understanding why nurses choose to work for an organization and ensuring this ‘employee value proposition’ is met; and II) identifying things that occur after nurses are hired that lead them to quit even though their initial job expectations were met. I. Primary factors that influence...
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...Nurse Burnout and Its Impact on Patient Safety Georgetown University Foundations of Health Systems and Policy NURO-624 September 12, 2013 Nurse Burnout and Its Impact on Patient Safety Patient safety encompasses the application of best practices that are geared towards achieving positive outcomes and promoting safety, and can serve as an indicator of quality in healthcare institutions; sustainable nursing workloads improve the quality of health care by reducing unsafe conditions, as well as reducing mortality and morbidity. Several literature reviews have clearly identified the consequences for patients when nurses are overtaxed or over utilized to bridge the gap of nursing shortages. According to Mckee et al, each patient added to nurses’ workloads (beyond four patients) is associated with a seven percent increase in mortality following common surgical procedures (McKee, M. 1999). Recent health reform legislation has further stimulated increased awareness and focuses on patient centered care, and emphasizes on the importance of the patients’ experience. Moreover, patients’ expectations of their caregivers to be positively engaged in their work and performing efficiently and effectively in a supportive environment are prudent. However, several challenges are being encountered by nurses, as they strive to meet the mandates of the aforementioned health care reform. Challenges resulting from unfavorable working conditions that are not conducive to the provision of patient...
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...2013 Amy Shoales Economic Tools and Concept The United States is presently confronting a nursing shortage which is likely to get worse in the future. The shortage is compelled by amount of reasons linked to the employment and maintenance of nurses. Less young females going into nursing schools as professional prospects in other areas have stretched. Countless eligible candidates are denied admission due to a scarcity of nursing instructors at schools. The student will present economic tools and concepts pertaining to health care issues (nursing shortage); the student will use marginal analysis and supply and demand curve to assess the issue of nursing shortage as it relates to health care. These tools are designed to explore and evaluate the nursing shortage. Registered nurses are the major set of health care specialists in America and Worldwide. It is important to understand the effects that a nursing shortage has on the economy and the health care system. Supply and Demand Supply and demand curves are vital when considering the number of registered nurses available to provide services to patients in need of care. A good service is said to be scarce when more is desired than can be satisfied with available resources which means demand exceeds supply. Quantity and quality of care demanded are greater than quantity of nurses supplied (Lane & Grohmann 1995). Nursing is a professional fields in which the nurse provides services (good) to the patient. These services...
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...experience for many century the shortage of nurses. It is perceive by the health care industry the shortage of nursing supply than the demand across the country. The demand for nurses in every health care organization growth in a daily basic as the technology advance. The consumers are always demanding for more personalize and quality of health care services at the time they are seeking for health care delivery creating nurses supply to be less in every health organization. A few probable reasons for nursing shortage within the health care industry can be the number of nurses in the workforce with a close retiring date, immigrated nurses from other country that works under constrained work permit, and also the population growth. As population increase the requirement for health care providers and services the growth of nursing and medical providers’ shortage will be notable. According to Getzen (2007), “There has recently been a growing recognition that instead of a surplus, a future shortage of physicians may occur. Since the number of U.S. medical graduates has not kept pace with the growth in U.S. population” (Chapter 7, p. 161). The nursing shortage and medical providers has become extremely demanded within the health care industry to provide a quality of health care. The following information will define economic concepts such as supply curve, demand curve, marginal analysis, and elasticity. According to Caron (2004), “Currently, the emerging shortage of RN’sposes a real threat...
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...{text:toc-mark-start} Standing on the main corner of a Sydney or Melbourne street one can hear various and different languages and dialects from around the world. Recent decades have coincided with the rapid globalisation in Australia society, due to a main reason is the government’s immigration program as skilled worker migration. This program has been very much impacted on Australia labour force. According to Australia penetrates into the ageing society, a serious skilled labour shortage is occurred in many industries. {text:toc-mark-end} {text:toc-mark-end} {text:toc-mark-end} Especially, the nursing industry is mainly affected by the aging population issue. Because of falling mortality rate, life expectancy and declining fertility rate, demand for nursing workforce is rapidly increasing in number. So, the solution that the government came up with the shortage of nurses was the General Skills Migration where overseas nurses can work in Australia. Through the skilled worker program, as many as number of lack of nursing labour force could be replaced by immigrated nurses. Introduction Understanding and respect for different culture is one of valuable moral principles in these days as multiculturalism society. According to Bennett (n.d.), multiculturalism is defined that the emergence of the term is strongly associated with a growing realisation of the unintended social and cultural consequences of large-scale immigration. The influx of migrant skilled workers, foreign wives, business...
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...a looming nursing crisis in health facilities. This problem has posed crisis towards establishing better health for those in need. The primary concern concerning this looming nursing shortage is identifying the root cause. Apparently, it appears as if that this crisis established its primary source in nursing training and retention in hospitals, care facilities, and other institutions. It appears as if there is serious downfall in the practicum of nurse-executive. Consequently, the concerned authority seems to portray weakness strategies in conducting this nursing practicum that has led to shortages of faculty. The big inquiry is whether these training facilities offer standardized training that would present the needed feedback facilitating nursing transition and retaining nursing staff. The central focus would then be whether this strategy would pose positive impacts in nursing training. This capstone project will explore these nursing concepts with a primary intention of presenting the root cause of nursing crisis in health facility. Annotated Bibliography Seago, A. J., Alvarado, A., Keane, D., Grumbach, K., & Spetz, J. (2006). The nursing shortage: is it really about image? Journal of Health Management, 51(2), 96-10. A research conducted in tertiary institutions Central Valley by Seago and the rest confirmed that nursing occupation lagged behind other occupations. This perspective is attributed by work independence perception and the perception that nursing is women’s...
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...hospitalized patients in the United States heightens concerns about professional competency. Nurses and other healthcare professionals are under increased pressure to provide safe, effective patient care. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. This paper will compare the differences between an Associate degree prepared nurse (ADN) and a Baccalaureate degree prepared nurse (BSN). Education Differences An ADN or associate degree nurse is as a nurse with two to three years training, usually at a community college or technical school. The curriculum usually consists of fundamentals, the basics of nursing and clinicals. A BSN or baccalaureate prepared nurse is a nurse with four or five years of training usually at a University. With the BSN, a nurse will have to think outside the box, use credible research, theory, leadership skills, all of which will make the nurse a better critical thinker, and in turn her patients will be safer. Both ADN and BSN will be qualified to take the NCLEX exam upon graduation from either community college or a university and become RNs. ADNs get primarily fundamental education in school consisting of formulating care plans and a basic understanding of concepts such as maternal child, psychology and pediatrics. They seem very prepared to do direct patient care right out of school since they have an equal...
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...2012 WHY ARE NURSES LEAVING? Nursing shortage has created a serious challenge in the health care delivery system, as there are not enough nurses to meet the patient’s demand. This shortage is a major concern in the health care system as it has a great impact on the quality of care to be provided. It was stated that by the nursing workforce in the United States, that registered nurse (RN) shortage may exceed five hundred thousand by the year 2025 (American Association of Colleges of Nursing [AACN], 2010; Cipriano, 2006; United States Department of Health and Human Services,2002). Several factors have contributed to Registered Nurses (RNs) leaving clinical nursing practice. These includes job dissatisfaction, increase in age of working nurses, verbal and physical abuse from managers, physicians and co-workers, lack of support from members of staff, fatigue and exhaustion due to work overload, and retention and recruitment. This situation can be improved by ensuring adequate nurse to patient ratios by reducing work load, promoting respects of nurses, giving rewards and recognizing nurses for a job well done, empowering nurses and nursing management, and increasing recreational activities for nurses to reduce fatigue and burnout. Purpose and Research Questions The study was conducted to identify the factors why RNs are leaving clinical nursing practice, what their expectation from the Nursing Management, job satisfaction and...
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...Health Care Workforce Shortages The access to quality healthcare is at risk due to the healthcare workforce shortages. The shortages include all members of the hospital work staff from nurses to primary care physicians to highly trained surgeons. Many hospitals do not have enough nurses to tend to the patients. The United States is projected to have a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care. ("AACN") The enrollment in for educational programs for medical professions whether hospital-based or in colleges and universities has declined significantly. There are simply not enough graduates to fill existing or anticipated vacancies. There are other issues that add to the shortages of nurses in the healthcare workforce. Such as; insufficient staffing which is raising the stress level of nurses, impacting job satisfaction, and driving many nurses to leave the profession. The high turnover and vacancy rates have an impact on healthcare. Insufficient nurse staffing is related to higher patient mortality rates. The mortality risk for patients was about 6% higher on units that were understaffed as compared with fully staffed units. (Clark) The mortality risks also increases when...
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...The Prospective of Nursing Outline Andreana Bakardzhieva Grand Canyon University: NRS- 440 V February 16, 2014 The prospective of Nursing Outline Nursing plays a specific and vital role in reconstructing and managing the nation’s health and related concerns. Nurses perform frontline duties and are an essential component in the American’s well-being care. Nursing prospective and health care are connected for the time to come. It is substantial to assure health care institutions carry the capacity and work force with proficient abilities to face the present and upcoming requirements (IOM, 2010). The ongoing nursing shortage will affect the way that the organizations will demonstrate unharmed, sufficient care. Nursing deficit presents a serious matter to the safety and satisfaction of health care. Sadly there is an extended remaining list for learners to enter the nursing schools. Also the number of nurse graduates is insufficient for the health care needs (IOM, 2010). This paper will discuss Robert Wood Johnson’s Foundation core, analyze how the institutions are assessing the nursing shortage during the programs and campaigns and effect on the nursing prospective in the nation to find solution for the nursing deficit. The Robert Wood Johnson Foundation (RWJF) concentrates on promoting well-being and addressing the health problems that the nation has to deal with. The corporation is the county’s major philanthropy dedicated to wellness care (RWJF, 2012). The committee collaborates...
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...part of the patient care and recovery process. To many patients, nurses are the health care professionals they see most often. Additionally, patients seeking care in outpatient clinics may not be aware of the number of hours nurses work. However, short stay and long stay patients see the same nurses over many shifts. What they may not realize is how many hours RNs work in a given 24-hour period to provide continuous patient care. According to Bae (2012a), a 2004 research study found that “43% of U.S. RNs worked more than 40 hours per week and about 9% worked more than 60 hours per week” (p. 205). In most instances RNs work overtime to alleviate staff shortages in their units. According to Bae (2012b), staff shortage in hospitals is not a new phenomenon and many researchers in health care system contend that such chronic shortage of nurses has a direct and negative impact on patient care (Bae, 2010; Bae, 2012b, Bae, Brewer, & Faan, 2012). For example, in several of her research articles, Bae (2010, 2012a, & 2012b) cited several research articles where researchers have found that the long hours worked by RNs are at the root of many adverse patient outcomes. Anecdotal evidence should suggest that anyone working long hours over an extended period of time will experience fatigue and decreased working performance. However, the health care system, as a whole, has not adopted the recommended standards from the Institute of Medicine (IOM) of “no more than 12 hours in a 24-hour...
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...continue to grow and shape our future including: the nursing workforce, innovative medical technology, etc. As healthcare needs continue rise and the population ages, I believe a shortage in nursing may be imminent based on these subsequent rationales that are discussed. On March 23, 2010 the Patient Protection and Affordable Care Act (ACA) was signed into law. Lanthrop and Hodnicki stated in their article, “It is the most expansive healthcare reform legislation in the United States (US) since the creation of Medicare and Medicaid in 1965” (Lathrop, 2014). The healthcare reform was put into legislation to decrease the number of uninsured Americans by providing accessible, affordable, quality healthcare. In 2011, it was predicted that the number of Americans uninsured would be reduced by more than half when the Act is fully implemented (Rosenbaum, 2011). “The law will result in health insurance coverage for about 94% of the American population, reducing the uninsured by 31 million people” (Rosenbaum, 2011). With the expanded access to health insurance provided by this law, more and more people are now seeking health care. Because of this new trend, the supply and demand for nurses and other healthcare professionals will be unbalanced. Another rationale for shortages has to do with the retirement of the aging population in the nursing workforce. The National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers conducted a survey in 2013 indicated...
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...Identify and describe three reasons there may be a physician shortage rather than a surplus in the United States. One reason physician preferences now favor a more “controllable lifestyle”. This factor stems from the increasing number of women in the workforce, but it affects men as well. Generally, younger physicians seek a different lifestyle that allows for weekends off, limits on the number of hours worked per week, and other amenities that allow for activities outside the workplace. Taken together, these preferences have had and will probably continue to have the effect of reducing the amount of time available for patient care (Williams & Torrens, 2008 p.270). Secondly, within the general increase in the U.S. population, there exists the ever-increasing lifespan of Americans, with their attendant levels of chronic conditions. In 2000, 12.4 percent of the U.S. population was 65 years of age or older; in 2050, the figure is projected to be 20.6 percent. This change will produce a steadily increasing demand for physician services and a consequent increase in the need for physicians (Williams & Torrens, 2008 p.270). Thirdly there is also a factor of using physician substitutes or extenders in health care delivery. Such as nurse practitioners, and physician assistants, among others were increasingly used to provide primary care, in which there would be less pressure to increase physician supply. Another reason for shortage could be a relatively new movement by payers and insurers...
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...Emerging Trends in Nursing There are many trends emerging today that will have an impact on our future. No one knows exactly what the future will bring, we as humans are only capable of making predictions. One of the most prominent areas seen affected by emerging trends in the past and present is the healthcare field. Various aspects of healthcare will continue to grow and shape our future including: the nursing workforce, innovative medical technology, etc. As healthcare needs continue rise and the population ages, I believe a shortage in nursing may be imminent based on these subsequent rationales that are discussed. On March 23, 2010 the Patient Protection and Affordable Care Act (ACA) was signed into law. Lanthrop and Hodnicki stated in their article, “It is the most expansive healthcare reform legislation in the United States (US) since the creation of Medicare and Medicaid in 1965” (Lathrop, 2014). The healthcare reform was put into legislation to decrease the number of uninsured Americans by providing accessible, affordable, quality healthcare. In 2011, it was predicted that the number of Americans uninsured would be reduced by more than half when the Act is fully implemented (Rosenbaum, 2011). “The law will result in health insurance coverage for about 94% of the American population, reducing the uninsured by 31 million people” (Rosenbaum, 2011). With the expanded access to health insurance provided by this law, more and more people are now seeking health care....
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...One of the current issues in nursing today is whether or not there should be mandatory nurse-patient ratios. The article titled, “Mandatory Nurse-Patient Ratios” discusses the controversy about whether there should be mandatory ratios and how they can affect nurses and patient outcomes. Currently the state of California is the only state in the United States with mandatory nurse-patient ratios while 17 others have introduced legislation. Since California has passed legislation in 2005 there has not been any experimental evidence reported to support these ratios with more desirable patient outcomes. One of the positive outcomes for nurses is that it has made more jobs available but unfortunately has increased their workload because employers are reducing the number of ancillary staff which can lead to increased stress and burnout. The mandatory nurse-patient ratios claim to address the imbalance between patient needs and nursing resources but do not address the different levels of complex treatment required among patients. Nurses must understand their importance and advocate effectively for themselves and their patients. Providing quality research, lobbying, collaborating among members of the healthcare team and becoming more powerful with the help of special interest groups will help to make employers responsible for their legal obligations. This issue will affect me professionally because I am about to graduate from nursing school and will be actively looking for a position...
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